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Health-related quality of life parameters as prognostic factors in a nonmetastatic breast cancer population : an international multicenter study

(2004) JOURNAL OF CLINICAL ONCOLOGY. 22(16). p.3381-3388
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Abstract
Purpose: The purpose of this research was to evaluate whether baseline health-related quality of life (HRQOL) parameters are prognostic factors for survival in locally advanced breast cancer patients. Although the literature highlights the important role of HRQOL parameters in predicting survival in advanced metastatic disease, little evidence exists for earlier stages. Patients and Methods: The overall sample consisted of 448 patients randomly assigned to receive cyclophosphamide, epirubicin, and fluorouracil versus epirubicin, cyclophosphamide, and granulocyte colony-stimulating factor. Patients were enrolled in 12 countries. HRQOL baseline scores were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30. The Cox proportional hazards regression model was used for both univariate and multivariate analyses of survival. In addition, a bootstrap resampling technique was used to assess the stability of the outcomes. Bootstrap results were then applied for model averaging purposes as a means to account for the observed model selection uncertainty. Results: The final multivariate model retained inflammatory breast cancer (T4d) as the only factor predicting overall survival (OS) with a hazard ratio of 1.375 (95% CI, 1.027 to 1.840; P = .03). The presence of inflammatory breast cancer lowers the median survival time from 6.6 to 4.2 years (36% reduction). None of the preselected HRQOL variables were prognostic for OS or disease-free survival, in either the univariate or multivariate analysis. Conclusion: Our findings suggest that baseline HBQOL parameters have no prognostic value in a nonmetastatic breast cancer population.
Keywords
COX REGRESSION, EORTC QLQ-C30, CHEMOTHERAPY, SCORES, SURVIVAL, ONCOLOGY, MODEL, WOMEN, TRIAL, IDENTIFICATION

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Chicago
Efficace, F, P Therasse, MJ Piccart, C Coens, Kristel Van Steen, M Welnicka-Jaskiewicz, T Cufer, et al. 2004. “Health-related Quality of Life Parameters as Prognostic Factors in a Nonmetastatic Breast Cancer Population : an International Multicenter Study.” Journal of Clinical Oncology 22 (16): 3381–3388.
APA
Efficace, F, Therasse, P., Piccart, M., Coens, C., Van Steen, K., Welnicka-Jaskiewicz, M., Cufer, T., et al. (2004). Health-related quality of life parameters as prognostic factors in a nonmetastatic breast cancer population : an international multicenter study. JOURNAL OF CLINICAL ONCOLOGY, 22(16), 3381–3388. Presented at the 40th Annual meeting of the American Society of Clinical Oncology.
Vancouver
1.
Efficace F, Therasse P, Piccart M, Coens C, Van Steen K, Welnicka-Jaskiewicz M, et al. Health-related quality of life parameters as prognostic factors in a nonmetastatic breast cancer population : an international multicenter study. JOURNAL OF CLINICAL ONCOLOGY. 2004;22(16):3381–8.
MLA
Efficace, F, P Therasse, MJ Piccart, et al. “Health-related Quality of Life Parameters as Prognostic Factors in a Nonmetastatic Breast Cancer Population : an International Multicenter Study.” JOURNAL OF CLINICAL ONCOLOGY 22.16 (2004): 3381–3388. Print.
@article{5907603,
  abstract     = {Purpose: The purpose of this research was to evaluate whether baseline health-related quality of life (HRQOL) parameters are prognostic factors for survival in locally advanced breast cancer patients. Although the literature highlights the important role of HRQOL parameters in predicting survival in advanced metastatic disease, little evidence exists for earlier stages. 
Patients and Methods: The overall sample consisted of 448 patients randomly assigned to receive cyclophosphamide, epirubicin, and fluorouracil versus epirubicin, cyclophosphamide, and granulocyte colony-stimulating factor. Patients were enrolled in 12 countries. HRQOL baseline scores were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30. The Cox proportional hazards regression model was used for both univariate and multivariate analyses of survival. In addition, a bootstrap resampling technique was used to assess the stability of the outcomes. Bootstrap results were then applied for model averaging purposes as a means to account for the observed model selection uncertainty. 
Results: The final multivariate model retained inflammatory breast cancer (T4d) as the only factor predicting overall survival (OS) with a hazard ratio of 1.375 (95\% CI, 1.027 to 1.840; P = .03). The presence of inflammatory breast cancer lowers the median survival time from 6.6 to 4.2 years (36\% reduction). None of the preselected HRQOL variables were prognostic for OS or disease-free survival, in either the univariate or multivariate analysis. 
Conclusion: Our findings suggest that baseline HBQOL parameters have no prognostic value in a nonmetastatic breast cancer population.},
  author       = {Efficace, F and Therasse, P and Piccart, MJ and Coens, C and Van Steen, Kristel and Welnicka-Jaskiewicz, M and Cufer, T and Dyczka, J and Lichinitser, M and Shepherd, L and de Haes, H and Sprangers, MA and Bottomley, A},
  issn         = {0732-183X},
  journal      = {JOURNAL OF CLINICAL ONCOLOGY},
  language     = {eng},
  location     = {New Orleans, LA, USA},
  number       = {16},
  pages        = {3381--3388},
  title        = {Health-related quality of life parameters as prognostic factors in a nonmetastatic breast cancer population : an international multicenter study},
  url          = {http://dx.doi.org/10.1200/JCO.2004.02.060},
  volume       = {22},
  year         = {2004},
}

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